The volition of article 14, 15, & 16, and it does not consider transgender.
AIIMS Delhi has advertised for the recruitment of nursing officer on Wednesday 5th August 2020 vide advertisement no.106/2020. This vacancy is a combined vacancy for 13 AIIMS excluding AIIMS Bathinda, Bhopal and Telangana. The remarkable point that has brought all the attention to this vacancy is the implementation of the ratio of 80:20 in filling the post by females and male respectively. Thus restricting the numbers of posts for males to just 20% while 80 % of posts will be filled by female candidates. This advertisement has raised concern among millions of male nurses who were preparing for various examinations especially for AIIMS Nursing Officer post because of the premium nature of AIIMS institute. This binary decision leaves behind the transgenders too. Don’t they have a right to apply for the post? Male nurses are feeling disheartened and demoralized because of this black rule adopted by AIIMS Delhi which is the responsible institution for conducting this exam namely, NORCET 2020. The young energetic hearts who have been very eager to serve as corona warriors and wanted to give out their best to the country by being medical defence warriors now stand in utmost disbelief and anguish by the biased decision made my AIIMS.
What is 80:20 Ratio
As per the decision taken by CIB i.e. Central Institute Body on 27th July 2019, under the chairmanship of the Health Minister and other members, a rule was adopted for recruitment of nursing officers with reservation in vacancy i.e 80% for female nurses and 20% for male nurses in upcoming exams of AIIMS. Initially, this was done to meet the requirements of female nurses in many departments (e.g. Gynaecology) for some privacy issues and as some clients objected to having male in their services. The nursing profession had been a female dominant profession since long and male nurses are very less in this profession. Recently with increasing private colleges and good scope of career in this field, it has attracted many males to join this profession. In the last few years, male nurses cracked many exams conducted for nursing positions in various institutes including Central government hospitals, Railway Health services, ESIC hospitals services, AIIMS institutions and many State-run Govt hospital setups. The increasing number of male nurses in the profession has demotivated administration to find problems in many areas and wards. The administration has taken it in a different way and with the ministry of health and family welfare, this decision of 80:20 Ratio was taken to stop the entry of male nurses in the field.
What is CIB
CIB is the acronym for Central Institute Body which is an empowered committee responsible for various functions of AIIMS. AIIMS Delhi was established under the AIIMS Act 1956. Later in 2012, Govt of India brought an amendment in this Act and paved a way for more such healthcare services institutes under a provision of PMSSY adopted by Govt of India in 2003. PMSSY was brought to correct the imbalance in the availability of tertiary level healthcare services and improve the quality of medical education. Under this scheme, there were two components in which first, was to set up new AIIMS and second one to upgrade the selected Govt medical colleges and institutes. In 2012, with an amendment of AIIMS Act 1956, the six new AIIMS became functional under new AIIMS Act (Amendment)2012. Later, many more AIIMS setups were introduced under PMSSY and at present, there are a total 22 AIIMS institutes all over India (Although some are under construction and some are in the early phase of operation). Due to this increase in the number of AIIMS institutions across the country, in order to create a suitable governance structure and to have more efficient and manageable governance, an Empowered Committee was constituted by an order passed by MoHFW on 12/01/2018. Later on 28/06/2018, MoHFW by its order No. Z-28016/83/2015-SSH the Empowered Committee was renamed as Central Institute Body of new AIIMS as an overarching governance structure. As per the recommendation of Bhan Committee, CIB was constituted under the chairmanship of Hon’ble Minister of Health and Family Welfare for efficient governance in New AIIMS.
CIB includes followings:
Chairman and all other members as per the institute body of AIIMS Delhi as constituted from time to time.
All Directors of New AIIMS as and when appointed.
Additional Secretary handling matters of PMSSY
Joint Secretary PMSSY.
Director of AIIMS Delhi will be member Secretary who will provide secretarial support to the CIB. The decisions taken by CIB may be adopted by all New AIIMS and same may be endorsed by their respective GBs (General Body) and IBs( Internal Body). All AIIMS which are established under a common AIIMS Act will be governed by AIIMS Delhi. It will provide uniformity in major policy matters across all AIIMS.
Functions of Central Institute Body (CIB):
It considers all common policy matters like human resource, recruitment, selection, training and others.
Any other such matter is common to two or more Institutes.
All proposals of capital expenditure by any New AIIMS is more than 100 crores are also envisaged to be placed before CIB.
Why this 80:20 Ratio rule of CIB is creating rucksacks among male nurses:
As per information available on the website of Indian Nursing Council as on 9th September 2017, there are more than 3000 colleges and schools of nursing recognised by INC and among them only includes 100 are government institutes. Although in many govt institutes, the number of male nurse trainees are very less or nil but in private institutions, there is no restriction for males to enrol as nurse trainees. Recently, the various pay commission had recommended the higher pay and allowances, ease of doing training in available institutes, 3 years diploma, 4 years degree and other higher courses like PhD, the soundtrack of availability of jobs, good placements and security of services. All these have attracted even the males to join nursing training. However, this new order based on gender discriminates the values, efficiency, and morale of males. Although, in the medical setup, there are no such criteria to differentiate the work based on gender. In the medical profession, according to one of a study conducted in 2001 Census, the male to female Ratio in allopathy doctors is 4.9 and as per another study based on 2011 census and published in the medical journal, Lancet, only 17% of all allopathy doctors are female whereas the same Ratio for nurses is just 0.2, showing a negligible presence of male nurses in the nursing profession. Although these studies are a decade older and in 2020, numbers might have increased slightly. But even after that, the total number of female nurses are more and the justification given by CIB is not as per law as the data shows the other story.
Legal Aspect for 80:20 Ratio rule for recruitment of nursing officer in AIIMS:
The nursing profession is considered a specialized profession and cannot be replaced with any other profession as it needs a quality type of special training. It is science and arts both. As a profession, anybody who has been trained in this field is eligible for a license to practice as a licentiate nurse in clinical areas and academic areas. Moreover, in the constitution of India, under Fundamental Rights, Rights to Equality, the Articles 16 which defines, “Article 16 guarantees equality to an opportunity to all citizens in the matter of appointment to any office or any other employment under the state.” Thus, we can see here that the legality of the above rule also stands for violation of fundamental rights of individuals based on the factor that one is male while another is female.
Violation of article 14, 15, 16 and 19
Part III of the Indian constitution which incorporates the Fundamental Rights of individuals, from Articles 14 to 32 and for analysing this issue. I want to highlight the article 14,15,16 and 19 which are in this case of 80:20 Ratio ruled out by CIB of AIIMS violates these fundamental rights. Article 14 which Equality before law or equal protection of law throughout the territory of India, whereas the article 15 which prohibits the discrimination on the ground of religion, race, caste, sex or place of birth. Articles 16 which defines the equal opportunity for all citizens in matters relating to employment in the office of state. In this article, no citizen shall, on the ground only of religion, race, caste, sex, descent, place of birth, residence or any of them, be ineligible for, or discriminated against in respect of any employment or office under the state. While Article 19 which provides in clause 1 of subclause “g” to practice any profession, or to carry on any occupation, trade or business. Thus by making a notification of 80:20 Ratio in the recruitment of nursing officer clearly violates the above-said type of Fundamental rights conferred in various articles of the constitution.
Healthcare professions are often classified as per skill and skill specialization. HCWs are highly skilled workers and are engaged with life-saving measures and emergency nature of the profession. CIB of AIIMS has provided the ground for restriction of male Nurses to 20% only on the basis of the comfort of clients getting admitted in the hospital, on the aspect I want to mention that health care profession is not hospitality type of profession just like airlines, hotels where comfort zone of clients is utmost important. The medical profession is a highly skilled profession that needs accuracy, to handle life-threatening and emergency situation, provide the highest level of holistic, preventive and promotive care which sideline the comfort zone of clients coming to the hospital for purpose of these measures, which doesn’t define the reasons given by CIB for this recruitment by 80:20 Ratio. Thus this is again a baseless, clueless as for comfort zone situation which is absent in other cadres of health care workers like doctors and other paramedics. It is just to restrict the male Nurses to enter into these type of premium institutions.
The decision to reserve 80 % seats for female Nursing officers by CIB of AIIMS is totally against law and which is not based on any study made, any data’s or any other ground. It’s just a restriction for male Nurses to come into service in these institutes, for unknown reasons of members of the body. For reservation for any category, it needs to be strongly provided by enacting a law, ordinance or any other mode which generally based on various data’s and must be passed in both houses of parliament. Reserving the higher number of seats for a particular group is not any base for such provision to make a reservation. It needs a large part to provide data and need the reasons for these types of conclusion. This is only as it seems that the egoistic nature of members of CIB to restrict the male Nurses to enter into the profession, thus violating the fundamental rights of individual and making a mockery of the Indian constitution.
Efforts to remove this Rule of 80:20 ratio by CIB
After the CIB meeting, this rule was publicly open as in minutes of the CIB. Once this rule was framed in the CIB meeting held on 27th July 2019 under the chairman of Health minister, there was no objection earlier either from individuals or by any unions of any AIIMS. This was because many of the serving people were not well aware of it and those who are unemployed were not familiar with such policy protocols. The main issue arose when the first recruitment vacancy was released by AIIMS Delhi in January 2020 and Patna AIIMS has applied this rule to take 80 % females and 20% male candidates for nursing officer vacancy. At that time people started to oppose the rule. Many unemployed nurses went to CAT for taking stay on the vacancies but they didn’t get success.
AIIMS Nurses Union Delhi has written to the Hon’ble Health minister to revert this rule and demanded open recruitment for all. AIIMS Nurses Union has approached the ministry for almost 5 times but all in vain. Meanwhile, many in-service candidates along with unemployed Nurses have started to give their application against this rule to ministry, MPs of their constituencies and even written to PMO.
In the last week of May 2020, male Nurses from across the country went for social sites online strike as the country was under lockdown and no one was able to meet. The dedicated team of some male Nurses from various institutes has taken up a Twitter account to tweet with hashtags of saving male nurses (#save_male_nurses) on 28th May 2020. This hashtag trended at number one in India on 28th May. This hashtag on Twitter was tweeted to the health minister, secretary health, various news channels, MPs and PMO. Even after a successful hashtag twitter campaign, there were no effects on ministerial officers and rule was continued on board.
Now on 5th August 2020 when AIIMS Delhi has released the vacancies for 15 AIIMS for recruitment of nursing officer, the notification raised the eyebrows again as it has mentioned about this rule again and this time all there will be only one combined exam namely NORCET 2020 conducted by AIIMS Delhi for filling up the posts. This has caused grave anger in the hearts of male nurses across the country. This is because Nurses are always treated as Nurses without any gender defined variant. Being a nurse is the noblest cause of life. It has a holistic approach and we are lucky that we are part of this noble profession. Now the government and some of the institute heads have started to take revenge for the profession, they have brought this discriminatory policy through CIB and it has been endorsed by all AIIMS, thus creating a blockage for the unemployed male Nurses.
Nature has created male and female as complementary to each other and some people have brought this biased, gender-based rule which is also against the basic provision of fundamental rights conferred in the constitution of India. At present, the situation is becoming wider and wider and many people are angry over the issue and are also planning to oppose it at various levels including legal consideration, agitation by various unions and some type of activities like satyagraha, Halla Bol, black badges, work down and meeting the MPs of their constituencies, ministers and every possible way they can afford. Unemployment is already rising and people who have spent lacs of rupees in the training of Nursing, are now feeling abandoned, feeling stressed, brutalised and not being able to serve the country by becoming frontline warriors is making them distressed. Being a nurse now seems a curse for male nurses. It is high time to think for male nurses as from female counterparts as the existence of male and female is complementary and it needs a balance where it can be rectified by removing this type of gender-based blatant rule by the profession as it doesn’t mean anything at all. For consideration of other available options, it needs to be taken by various federations, unions, and associations, leadership and the last available sound option is for legal help from judiciaries.
Ghewar Chand (RN, RM, MA history, PGDHRL, MBA HR, PGDHR) currently working as a Chief Nursing Superintendent at Northern Railway Centre Hospital, New Delhi. He is not only passionate to care for the needy population but also to fight for their nurse's rights. He is General Secretary of ARNI( Association of Railway Nurses of India).